The Determinants of Ethical Principle Implementation in Nursing
Abstract
The determinant of nursing ethics practice is not identified yet. This problem affects the ethical behavior of nurses in performing
nursing care. According to that, it was influencing satisfaction and patient well-being. This study aims to identify the determinants
of the ethical principles application in nursing. Descriptive, correlation, cross-sectional design was applied, through simple
random sampling to 120 nurses. Data collecting used questionnaires, with univariate, bivariate, and multivariate analyzes. Determinants
of nursing ethic application principle were job characteristics, nurses knowledge related to nursing ethics, supervision
by supervisor, relationship with colleagues, awards, the role of head nurse, and tenure (p = <0,001-0,049). The most dominant
variable was job characteristics (p <0,001). These factors need an attention by hospital manager to keep evaluating the other factors
in order to improve the application of ethical principles in nursing.
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References
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32.4.250.
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Gastmans, C. (2010). “It’s intense, you know”: Nurses’
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Medical Health Care Philosophy, 13, 41-48. doi:
10.1007/s11019-009-9203-1.
[9] Desphande, S. P. & Joseph, J. (2008). Impact of
emotional intelligence, ethical climate and behavior of
peer on ethical behavior of nurses. Journal of Business
Ethics, 85(3), 403-410. doi:10.1007/s10551-008-9779-z.
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Nursing’s legacy and moral imperative. Advances in
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http://www.nursingcenter.com/lnc/journalissue?Journal
_ID=54009&Issue_ID=598140.
[12] Friedman, M., Cooper, A. H., Click, E., & Fitzpatrick, J.
J. (2011). Specialized new graduate RN critical care
orientation: Retention and financial impact. Nursing
Economics, 29, 7-14. Diunduh dari
http://www.nursingeconomics.net.
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nursing: Some proposals for ethics education. Nursing
Ethics, 9(5), 494-507.
doi:10.1191/0969733002ne539oa.
[14] Gatot, D. B. & Adisasmito, W. (2005). Hubungan
karakteristik perawat, isi pekerjaan, dan lingkungan
pekerjaan terhadap kepuasan kerja perawat di Instalasi
Rawat Inap RSUD Gunung Jati Cirebon. Makara
Kesehatan, 9(1), 1-8. Diunduh dari
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10.1046/j.1365-2850.2003.00544.x.
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The factors facilitating and inhibiting effective clinical
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[18] Harrison, J. P., Lambiase, L. R., & Zhao, M. (2010).
Organizational factors associated with quality of care in
US teaching hospitals. Journal of Health Care Finance,
36(3), 1-12. Diunduh dari
http://www.aspenpublishers.com.
[19] Hayes, B., Bonner, A. N. N., & Pryor, J. (2010). Factors
contributing to nurse job satisfaction in the acute
hospital setting: A review of recent literature. Journal of
Nursing Management, 18, 804-814. doi:10.1111/j.1365-
2834.2010.01131.x.
[20] Huitt, W. (2003). A transactional model of the teaching/
learning process. Diunduh dari
http://www.edpsycinteractive.org/materials/tchlrnmd.ht
ml.
[21] Inga-Britt Lindh, Severinsson, E., & Berg, A. (2007).
Moral responsibility: A relational way of being. Nursing
Ethics, 14(2), 129-40. doi:10.1177/0969733007073693.
[22] Irani, T., Rudd, R., Gallo, M., Ricketts, J., Friedel, C., &
Rhoades, E. (2007). Crittical thingking instrumentation
manual. Diunduh dari http://step.ufl.edu/resources/
critical_thingking/ctmanual.pdf.
[23] Kane-Urrabazo, C. (2006). Management’s role in
shaping organizational culture. Journal of Nursing
Management, 14, 188-194. Diunduh dari
http://www.sjsu.edu/people/phyllis.connolly/courses/c1
7/s1/kane_umanageroleorgcul20060177.pdf.
[24] Kim Lützén, Dahlqvist, V., Eriksson, S., & Norberg, A.
(2006). Developing the concept of moral sensitivity in
health care practice.Nursing Ethics, 13(2), 187-96.
doi:http://dx.doi.org/10.1191/0969733006ne837oa.
[25] Lanchman, V. D. (2012). Applying the ethics of care to
your nursing practice. Medical Surgical Nursing, 21(2),
112-4, 116. Diunduh dari
http://search.proquest.com/docview/1008665095?accou
ntid=17242.
[26] Leuter, C., Petrucci, C., Mattei, A., Tabassi, G., &
Lancia, L. (2013). Ethical difficulties in nursing,
educational needs and attitudes about using ethics
resources. Nursing Ethics, 20(3), 348-58.
doi:10.1177/0969733012455565.
[27] Lin, C., Lu, M., Chung, C., & Yang, C. (2010). A
comparison of problem-based learning and conventional
teaching in nursing ethics education. Nursing Ethics,
17(3), 373-82. doi:10.1177/0969733009355380.
[28] McFadzean, F., & McFadzean, E. (2005). Riding the
emotional roller-coaster: A framework for improving
nursing morale. Journal of Health Organization and
Management, 19(4), 318-39. Diunduh dari
http://search.proquest.com/docview/197367435?account
id=17242.
[29] Mckinstry, B. (2000). Do patients wish to be involved in
decision making in the consultation? A cross sectional
survey with video vignettes. British Medical Journal,
321(7265), 867-871. Diunduh dari http://
http://www.ncbi.nlm.nih.gov/pubmed/11021866.
[30] McKnight, H. D., Ahmad, S., & Schroeder, R. G.
(2001). When do feedback, incentive control, and
autonomy improve morale? The importance of
employee-management relationship closeness. Journal
of Managerial Issues, 13(4), 466-482. ISSN: 10453695.
[31] Mohajjel-Aghdam, A., Hassankhani, H., Zamanzadeh,
V., Khameneh, S., & Moghaddam, S. (2013).
Knowledge and performance about nursing ethic codes
from nurses' and patients' perspective in Tabriz
Teaching Hospitals, Iran. Journal of Caring Science,
2(3), 219-227. Diunduh dari:
http://search.proquest.com/docview/1625962293?accou
ntid=17242.
[32] Negarandeh, R., & Gobady, S. (2001). A survey of
knowledge and attitude of Zanjan Hospitals’ nurses and
midwives toward ethical issues. Journal of Zanjan
University of Medical Sciences and Health Services,
9(36), 55-59. Diunduh dari
http://en.journals.sid.ir/ViewPaper.aspx?ID=54070.
[33] Numminen, O., Van, d. A., & Leino-Kilpi, H. (2009).
Nurse educators' and nursing students' perspectives on
teaching codes of ethics. Nursing Ethics, 16(1), 69-82.
doi:10.1177/0969733008097991.
[34] Rest, J. R. (1979). Development in judging moral issues.
Minneapolis:University of Minnesota Press.
[35] Robbins, S. P. & Judge, T. A. (2013). Organizational
behavior (15th ed). USA: Prentice Hall.
[36] Rosenstein, A. H. (2002). Nurse-physician relationship:
Impact on nurse satisfaction and retention. American
Journal of Nursing, 102(6), 26-34. Diunduh dari
http://www.jstor.org/stable/3522841.
[37] Skoe, E. E. & Diessner, R. (1994). Ethic of care, justice,
identity, and gender: An extension and replication.
Merrill-Palmer Quarterly, 40(2), 272-289. Diunduh dari
http://www.jstor.org/stable/23087865.
[38] Skoe, E. E., Pratt, M. W., Matthews, M., & Curror, S. E.
(1996). The ethic of care: Stability over time, gender
differences, and correlates in mid- to late adulthood.
Psychology and Aging, 11(2), 280-292.
doi:http://dx.doi.org/10.1037/0882-7974.11.2.280.
[39] Snellman, I., & Gedda, K. M. (2012). The value ground
of nursing. Nursing Ethics, 19(6), 714-26. doi:
10.1177/0969733011420195.
[40] Sochting, I., Skoe, E. E., & Marcia, J. E. (1994). Careoriented
moral reasoning and prosocial behavior: A
question of gender or sex role orientation. Sex Roles: A
Journal of Research, 31(3/4), 131-147.
[41] Stringer, R. A. (2002). Leadership & organizational
climate: The cloud chamber effect (1st ed). New Jersey:
Pearson Education.
[42] Tronto, J. (1993). Moral boundaries: A political
argument for an ethic of care. New York: Routledge.
[43] Tronto, J. C. (1998). An ethnic of care. Generations,
22(3), 15-20. Diunduh dari
http://search.proquest.com/docview/212197942?account
id=17242.
[44] Van der Arend, A. J. G. & Remmers-van den Hurk, C.
H. M. (1999). Moral problems among Dutch nurse: A
survey. Nursing Ethics, 6(6), 468-482. doi:
10.1177/096973309900600603.
[45] Vanlaere, L., & Gastmans, C. (2007). Ethics in nursing
education: Learning to reflect on care practices. Nursing
Ethics, 14(6), 758-66.
doi:http://dx.doi.org/10.1177/0969733007082116.
[46] Zhang, Z. X., Luk, W., Arthur, D., & Wang, T. (2001).
Nursing competencies: Personal characteristics
contributing to effective nursing performance. Journal
of Advanced Nursing, 33(4), 467-474.
(2008). The essentials of baccalaureate education for
professional nursing practice. Washington, D.C.:
American Association of Colleges of Nursing. Diunduh
dari
http://www.aacn.nche.edu/Education/pdf/BaccEssentials
08.pdf.
[2] Balcanoff, K. (2013).The effect of communication on
hospital nursing morale and retention (Order No.
3551586). Tersedia dari ProQuest Dissertations &
Theses Global. (1288420375).
[3] Buchan, J., Ball, J., & Rafferty, A. M. (2003). A lasting
attraction? The ‘Magnet’ accreditation of Rochdale
Infirmary. Diunduh dari
http://www.lshtm.ac.uk/hsru/staff/PDFs/Rochdale.pdf
[4] Callaghan, M. (2003). Nursing morale: What is it like
and why? Journal of Advanced Nursing, 42(1), 82-89.
doi:10.1046/j.1365-2648.2003.02582.x.
[5] Chaousis, L. (2000). Organisational behavior. NSW:
Pretince Hall.
[6] Chickering, A. &Reisser, L.(1993). Education and
identity (2nd ed). San Francisco: Jossey-Bass.
[7] [Cottingham, S., DiBartolo, M., Battistoni, S., &
Brown, T. (2011). Partners in nursing: A mentoring
initiative to enhance nurse retention. Nursing Education
Perspectives, 32, 250-255. doi:10.5480/1536-5026-
32.4.250.
[8] [Denier, Y., Dierckx de Casterle, B., De Bal, N., &
Gastmans, C. (2010). “It’s intense, you know”: Nurses’
experiences in caring for patients requesting euthanasia.
Medical Health Care Philosophy, 13, 41-48. doi:
10.1007/s11019-009-9203-1.
[9] Desphande, S. P. & Joseph, J. (2008). Impact of
emotional intelligence, ethical climate and behavior of
peer on ethical behavior of nurses. Journal of Business
Ethics, 85(3), 403-410. doi:10.1007/s10551-008-9779-z.
[10] Dio, L. D., Saragovi, C., & Koestner, R. (1996).
Lingking personal values to gender. Sex Roles, 34(9/10),
621-635. doi: 10.1007/BF01551498.
[11] Falk-Rafael, A. (2005). Speaking truth to power:
Nursing’s legacy and moral imperative. Advances in
Nursing Science, 28: 212-223. Diunduh dari
http://www.nursingcenter.com/lnc/journalissue?Journal
_ID=54009&Issue_ID=598140.
[12] Friedman, M., Cooper, A. H., Click, E., & Fitzpatrick, J.
J. (2011). Specialized new graduate RN critical care
orientation: Retention and financial impact. Nursing
Economics, 29, 7-14. Diunduh dari
http://www.nursingeconomics.net.
[13] Gastmans, C. (2002). A fundamental ethical approach to
nursing: Some proposals for ethics education. Nursing
Ethics, 9(5), 494-507.
doi:10.1191/0969733002ne539oa.
[14] Gatot, D. B. & Adisasmito, W. (2005). Hubungan
karakteristik perawat, isi pekerjaan, dan lingkungan
pekerjaan terhadap kepuasan kerja perawat di Instalasi
Rawat Inap RSUD Gunung Jati Cirebon. Makara
Kesehatan, 9(1), 1-8. Diunduh dari
http://journal.ui.ac.id/upload/artikel/01_Hubungan%20k
arakteristik%20perawat_Dewi%Basmala.PDF.
[15] Gilligan, C. (1987). Moral orientation and moral
development in Kittay, E. F. & Meter, D. T (eds).
Women and Moral Theory. Totowa, NJ: Rowman&
Littlefield.
[16] Gulliver, P., Rowell, D., & Peck, E. (2003). Staff
morale in the merger of mental health and social care
organizations in England. Journal of Psychiatric and
Mental Health Nursing, 10, 101-107. doi:
10.1046/j.1365-2850.2003.00544.x.
[17] Habaghery, M. A., Salsali, M., & Ahmadi, F. (2004).
The factors facilitating and inhibiting effective clinical
decision making in nursing: A qualitative studi. Bio
Med Central Nursing, 3(2). doi:10.1186/1472-6955-3-2.
[18] Harrison, J. P., Lambiase, L. R., & Zhao, M. (2010).
Organizational factors associated with quality of care in
US teaching hospitals. Journal of Health Care Finance,
36(3), 1-12. Diunduh dari
http://www.aspenpublishers.com.
[19] Hayes, B., Bonner, A. N. N., & Pryor, J. (2010). Factors
contributing to nurse job satisfaction in the acute
hospital setting: A review of recent literature. Journal of
Nursing Management, 18, 804-814. doi:10.1111/j.1365-
2834.2010.01131.x.
[20] Huitt, W. (2003). A transactional model of the teaching/
learning process. Diunduh dari
http://www.edpsycinteractive.org/materials/tchlrnmd.ht
ml.
[21] Inga-Britt Lindh, Severinsson, E., & Berg, A. (2007).
Moral responsibility: A relational way of being. Nursing
Ethics, 14(2), 129-40. doi:10.1177/0969733007073693.
[22] Irani, T., Rudd, R., Gallo, M., Ricketts, J., Friedel, C., &
Rhoades, E. (2007). Crittical thingking instrumentation
manual. Diunduh dari http://step.ufl.edu/resources/
critical_thingking/ctmanual.pdf.
[23] Kane-Urrabazo, C. (2006). Management’s role in
shaping organizational culture. Journal of Nursing
Management, 14, 188-194. Diunduh dari
http://www.sjsu.edu/people/phyllis.connolly/courses/c1
7/s1/kane_umanageroleorgcul20060177.pdf.
[24] Kim Lützén, Dahlqvist, V., Eriksson, S., & Norberg, A.
(2006). Developing the concept of moral sensitivity in
health care practice.Nursing Ethics, 13(2), 187-96.
doi:http://dx.doi.org/10.1191/0969733006ne837oa.
[25] Lanchman, V. D. (2012). Applying the ethics of care to
your nursing practice. Medical Surgical Nursing, 21(2),
112-4, 116. Diunduh dari
http://search.proquest.com/docview/1008665095?accou
ntid=17242.
[26] Leuter, C., Petrucci, C., Mattei, A., Tabassi, G., &
Lancia, L. (2013). Ethical difficulties in nursing,
educational needs and attitudes about using ethics
resources. Nursing Ethics, 20(3), 348-58.
doi:10.1177/0969733012455565.
[27] Lin, C., Lu, M., Chung, C., & Yang, C. (2010). A
comparison of problem-based learning and conventional
teaching in nursing ethics education. Nursing Ethics,
17(3), 373-82. doi:10.1177/0969733009355380.
[28] McFadzean, F., & McFadzean, E. (2005). Riding the
emotional roller-coaster: A framework for improving
nursing morale. Journal of Health Organization and
Management, 19(4), 318-39. Diunduh dari
http://search.proquest.com/docview/197367435?account
id=17242.
[29] Mckinstry, B. (2000). Do patients wish to be involved in
decision making in the consultation? A cross sectional
survey with video vignettes. British Medical Journal,
321(7265), 867-871. Diunduh dari http://
http://www.ncbi.nlm.nih.gov/pubmed/11021866.
[30] McKnight, H. D., Ahmad, S., & Schroeder, R. G.
(2001). When do feedback, incentive control, and
autonomy improve morale? The importance of
employee-management relationship closeness. Journal
of Managerial Issues, 13(4), 466-482. ISSN: 10453695.
[31] Mohajjel-Aghdam, A., Hassankhani, H., Zamanzadeh,
V., Khameneh, S., & Moghaddam, S. (2013).
Knowledge and performance about nursing ethic codes
from nurses' and patients' perspective in Tabriz
Teaching Hospitals, Iran. Journal of Caring Science,
2(3), 219-227. Diunduh dari:
http://search.proquest.com/docview/1625962293?accou
ntid=17242.
[32] Negarandeh, R., & Gobady, S. (2001). A survey of
knowledge and attitude of Zanjan Hospitals’ nurses and
midwives toward ethical issues. Journal of Zanjan
University of Medical Sciences and Health Services,
9(36), 55-59. Diunduh dari
http://en.journals.sid.ir/ViewPaper.aspx?ID=54070.
[33] Numminen, O., Van, d. A., & Leino-Kilpi, H. (2009).
Nurse educators' and nursing students' perspectives on
teaching codes of ethics. Nursing Ethics, 16(1), 69-82.
doi:10.1177/0969733008097991.
[34] Rest, J. R. (1979). Development in judging moral issues.
Minneapolis:University of Minnesota Press.
[35] Robbins, S. P. & Judge, T. A. (2013). Organizational
behavior (15th ed). USA: Prentice Hall.
[36] Rosenstein, A. H. (2002). Nurse-physician relationship:
Impact on nurse satisfaction and retention. American
Journal of Nursing, 102(6), 26-34. Diunduh dari
http://www.jstor.org/stable/3522841.
[37] Skoe, E. E. & Diessner, R. (1994). Ethic of care, justice,
identity, and gender: An extension and replication.
Merrill-Palmer Quarterly, 40(2), 272-289. Diunduh dari
http://www.jstor.org/stable/23087865.
[38] Skoe, E. E., Pratt, M. W., Matthews, M., & Curror, S. E.
(1996). The ethic of care: Stability over time, gender
differences, and correlates in mid- to late adulthood.
Psychology and Aging, 11(2), 280-292.
doi:http://dx.doi.org/10.1037/0882-7974.11.2.280.
[39] Snellman, I., & Gedda, K. M. (2012). The value ground
of nursing. Nursing Ethics, 19(6), 714-26. doi:
10.1177/0969733011420195.
[40] Sochting, I., Skoe, E. E., & Marcia, J. E. (1994). Careoriented
moral reasoning and prosocial behavior: A
question of gender or sex role orientation. Sex Roles: A
Journal of Research, 31(3/4), 131-147.
[41] Stringer, R. A. (2002). Leadership & organizational
climate: The cloud chamber effect (1st ed). New Jersey:
Pearson Education.
[42] Tronto, J. (1993). Moral boundaries: A political
argument for an ethic of care. New York: Routledge.
[43] Tronto, J. C. (1998). An ethnic of care. Generations,
22(3), 15-20. Diunduh dari
http://search.proquest.com/docview/212197942?account
id=17242.
[44] Van der Arend, A. J. G. & Remmers-van den Hurk, C.
H. M. (1999). Moral problems among Dutch nurse: A
survey. Nursing Ethics, 6(6), 468-482. doi:
10.1177/096973309900600603.
[45] Vanlaere, L., & Gastmans, C. (2007). Ethics in nursing
education: Learning to reflect on care practices. Nursing
Ethics, 14(6), 758-66.
doi:http://dx.doi.org/10.1177/0969733007082116.
[46] Zhang, Z. X., Luk, W., Arthur, D., & Wang, T. (2001).
Nursing competencies: Personal characteristics
contributing to effective nursing performance. Journal
of Advanced Nursing, 33(4), 467-474.
Published
2018-01-25
How to Cite
DARMAYANTI, Ni Putu Emy; HANDIYANI, Hanny; KUNTARTI, Kuntarti.
The Determinants of Ethical Principle Implementation in Nursing.
Journal of Health Sciences and Medicine, [S.l.], v. 1, n. 2, p. 16-22, jan. 2018.
ISSN 2622-0555.
Available at: <https://ojs.unud.ac.id/index.php/jhsm/article/view/36987>. Date accessed: 18 apr. 2024.
Section
Articles
